go back

Pediatric Hydrolyzed or Amino Acid Enteral Formula

West Virginia rates for HCPCS B4161

Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit

Rates data updated July 2026.

How much rates vary

Facilitymedian $1 · 10th to 90th $1 to $1Professionalmedian $1 · 10th to 90th $1 to $1
$2$5$10$20$50facility $1professional $1

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1.12
Median
$1.12
Typical High
$1.12
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$1.12
Typical High
$1.12
Cigna
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.74
Median
$14.79
Typical High
$14.79